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HomeMy WebLinkAboutED CARROLL MOTOR COMPANY INC - INSURANCE CERTIFICATE (2)AC"Ra DATE (MM/DD/YYYY) ��- CERTIFICATE OF GARAGE INSURANCE 01/26/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(es) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the Policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Justin Bayern CONTACT Sentry Customer Service NAME: PHONE No, g00-447-0633 F',No: 888-533-7827 A/C EMAIL ADDRESS: businessproducts_ssdod'sentry.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Sentry Select Insurance Company 21180 INSURED INSURER B : Ed Carroll Motor Company Inc 3003 S College Ave INSURER C : Fort Collins, CO 80525-2535 INSURER D : INSURER E : INSURER F : COVERAGES PROD / CUSTOMER ID: CERTIFICATE #: 1042942 REVISION #: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSRD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GARAGE LIABILITY H HIRED AUTOS ANY AUTO ONLY %( NON -OWNED OWNED AUTOS USED AUTOS ONLY IN GARAGE BUSINESS 2557028004 03/01/2018 03/01/2019 AUTO ONLY (Ea accident) $ 500,000 OTHER THAN AUTO ONLY EA ACCIDENT $ 500,000 AGGREGATE $ 2,500,000 A GARAGE KEEPERS LIABILITY LEGAL LIABILITY X DIRECT BASIS X PRIMARY EXCESS 2557028004 03/01/2018 03/01/2019 X COMP / OTC LOG SPECIFIEDPERILSLOG 1 $ 920,000 $ X COLLISION LOG LOG 1 $ 920,000 $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES occurrence $ GRTL MED IXP (Any one person) $ PERSONAL R ADV INJURY $ AGGREGATE LIMIT APPLIES PER POLICY ❑ JECT LOG OTHER GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ A X UMBRELLA LIAR X EXCESS LIAR X OCCUR CLAIMS -MADE 2557028005 03/01/2018 03/01/2019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 15,000,000 DED I J RETENTION $ PRODUCTS - COMP/OP AGG $ 15,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/D(ECLMVE OFFICER/MEMBER EXCLUDED? Y / N (Mandatory in NH) ❑ If yes, describe under REMARKS below N / A PER M,E OTH- EERR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY UMrr $ REMARKS (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Refer to attached CERTIFICATE HOLDER CANCELLATION City of Fort Collins Risk Management SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 580 Fort Collins, CO 80522-0580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTH RIZ �WESENTATIVJ ACORD 30 (2016/03) 2557028 Sentry Select Insurance Company 1 00001 0000003651 18029 0 N Page 1 of 2 © 2010-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 01/26/2018 2DD4926E-E69C-4D4C-6C26-4E816AD1625F 0027020044343871694480522058080 AGENCY Justin Bayern POLICY NUMBER 2557029004 CARRIER Sentry Select Insurance Company ADDITIONAL REMARKS AGENCY CUSTOMER ID: X=00(2801 LOC #: ADDITIONAL REMARKS SCHEDULE Page 2 of 2 NAMEDINSURED Ed Carroll Motor Company Inc NAIC CODE 21180 1 EFFECTIVE DATE: 03/01/2018 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 30 FORM TITLE: Certificate Of Gara e Insurance Auto Dealers UMBRELLA WILL FOLLOW IN EXCESS OF UNDERLYING LIMITS. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. 2557028 The ACORD name and logo are registered marks of ACORD 01 /25/2018 Sentry Select Insurance Company